Protecting journalists from harassment, threats, detention or censorship helps keep us all safeby Michelle BacheletUN High Commissioner for Human Rights

Apr. 2020

UN High Commissioner for Human Rights Michelle Bachelet said she was alarmed by restrictive measures imposed by several States against the independent media, as well as the arrest and intimidation of journalists, saying the free flow information was vital in fighting COVID-19.

“Some States have used the outbreak of the new coronavirus as a pretext to restrict information and stifle criticism,” Bachelet said. “A free media is always essential, but we have never depended on it more than we do during this pandemic, when so many people are isolated and fearing for their health and livelihoods. Credible, accurate reporting is a lifeline for all of us.”

The UN human rights chief also noted that some political leaders had directed statements towards journalists and media workers that created a hostile environment for their safety and their ability to do their work.

According to the International Press Institute there have been over 130 alleged media violations since the start of the outbreak, including more than 50 reported instances of restrictions on access to information, censorship and excessive regulation of misinformation.

It reported that nearly 40 journalists have been arrested or charged in the Asia-Pacific, Americas, Europe, the Middle East and Africa for reports critical of the State response to the pandemic or for simply questioning the accuracy of official numbers of cases and deaths related to COVID-19. The actual number of media violations and arrests is probably far higher.

There have also been reports of journalists disappearing after publishing coverage critical of the COVID-19 response, and several news outlets have been closed by the authorities over their reporting.

“This is no time to blame the messenger. Rather than threatening journalists or stifling criticism, States should encourage healthy debate concerning the pandemic and its consequences. People have a right to participate in decision-making that affects their lives, and an independent media is a vital medium for this,” Bachelet said.

“Being open and transparent, and involving those affected in decision-making builds public trust and helps ensure that people participate in measures designed to protect their own health and that of the wider population and increases accountability.”

Additionally, independent media provide medical professionals and relevant experts a platform to speak freely and share information with each other and the public, she said.

The UN’s human rights chief echoed concerns raised by the Secretary-General about the “dangerous epidemic of misinformation” around the pandemic which generated confusion and more ill-health, and paid tribute to the journalists working in the independent media whose fact-checking provided truth and clarity.

“Journalists are playing an indispensable role in our response to this pandemic, but unlike the grave threats posed to other essential workers, the threats media workers face are entirely avoidable. Protecting journalists from harassment, threats, detention or censorship helps keep us all safe,” Bachelet said.

COVID-19: Exceptional measures should not be cover for human rights abuses and violations

As Governments face the formidable challenge of protecting people from COVID-19, UN High Commissioner for Human Rights Michelle Bachelet has called on them to ensure human rights are not violated under the guise of exceptional or emergency measures.

“Emergency powers should not be a weapon governments can wield to quash dissent, control the population, and even perpetuate their time in power,” Bachelet warned. “They should be used to cope effectively with the pandemic – nothing more, nothing less.”

States are able to restrict some rights to protect public health under human rights law, and also have certain additional powers if a state of emergency threatening the life of the nation is publicly declared. In either case, the restrictions need to be necessary, proportionate, and non-discriminatory. They also need to be limited in duration and key safeguards against excesses must be put in place.

Certain rights, including the right to life, the prohibition against torture and other ill-treatment, and the right not to be arbitrarily detained continue to apply in all circumstances.

To help States in their response to COVID-19, the UN Human Rights Office has issued new policy guidance on emergency and exceptional measures: http://bit.ly/2VISa20

“There have been numerous reports from different regions that police and other security forces have been using excessive, and at times lethal, force to make people abide by lockdowns and curfews. Such violations have often been committed against people belonging to the poorest and most vulnerable segments of the population,” the High Commissioner said.

“Shooting, detaining, or abusing someone for breaking a curfew because they are desperately searching for food is clearly an unacceptable and unlawful response. So is making it difficult or dangerous for a woman to get to hospital to give birth. In some cases, people are dying because of the inappropriate application of measures that have been supposedly put in place to save them,” Bachelet said.

“In some countries, thousands have also been detained for curfew violations, a practice that is both unnecessary and unsafe. Jails and prisons are high risk environments, and states should focus on releasing whoever can be safely released, not detaining more people.”

The guidance document stresses that, as in normal times, law enforcement officials should adhere to the principles of legality, necessity, proportionality and precaution.

“They should only use force when strictly necessary, and lethal force can only be used when there is an imminent risk to life,” Bachelet said.

Measures and laws introduced in some countries contain references to vaguely defined offences, coupled at times with harsh sentences, fuelling concerns they may be utilized to muzzle the media and detain critics and opponents. Although measures to restrict movement and assembly are legitimate in such circumstances, public confidence and scrutiny are essential for them to be effective.

“It is important to counter misinformation, but shutting down the free exchange of ideas and information not only violates rights, it undermines trust. False information about COVID-19 poses a huge risk to people. But so do bad policy decisions,” the High Commissioner said. “Undermining rights such as freedom of expression may do incalculable damage to the effort to contain COVID-19 and its pernicious socio-economic side-effects.”

The guidance sets out clearly that the measures should not only be necessary to achieve a legitimate public health objective, but that they should also be the “least intrusive” approach required to achieve that result.

“We have seen many States adopt justifiable, reasonable and time-limited measures. But there have also been deeply worrying cases where Governments appear to be using COVID-19 as a cover for human rights violations, further restricting fundamental freedoms and civic space, and undermining the rule of law,” Bachelet said.

Bachelet said that exceptional measures or a state of emergency should be subject to proper parliamentary, judicial and public oversight.

“Different countries are at different stages of the pandemic. Some are starting to come out of emergency measures, while others are extending or reinforcing them. The abiding principle must be that these measures are enforced humanely. Penalties for violating them should be proportionate, and not imposed in an arbitrary or discriminate way,” she added.

“Given the exceptional nature of the crisis, it is clear States need additional powers to cope. However, if the rule of law is not upheld, then the public health emergency risks becoming a human rights disaster, with negative effects that will long outlast the pandemic itself,” Bachelet said.

How are you supposed to wash your hands regularly if you have no running water or soap? How can you implement ‘social distancing’ if you live in a slum or a refugee camp? How are you supposed to stop crossing borders if you are fleeing from war? How are those with pre-existing health conditions going to take extra precautions if they already can’t afford or access the treatment they need?

Everyone is affected by the COVID-19 pandemic, but the impact may be felt by some more than others.

As coronavirus disease COVID-19 spreads further, it will continue to expose the inequalities that exist in our health systems.

It will expose the exclusion of certain groups from accessing care, either because of their legal status or because of other factors that make them a target of the state.

It will expose the under-investment in free public healthcare for all, which means that access to quality care will for some be based on purchasing power and not medical need.

It will expose the failure of governments - not just health services - to plan for and deliver services that meet the needs of everyone.

It will expose the life-threatening vulnerabilities caused by displacement, violence, poverty and war.

The people who will especially suffer will be those already neglected - due to austerity measures, who have fled because of war, who don’t have access to treatment for existing conditions because of privatised healthcare.

And it will also be those who can’t stock up on food because they already can’t afford a meal every night of the week, who are underpaid, overworked and deprived of sick leave, unable to work from home - and those trapped in conflict zones under bombing and siege.

And how are you supposed to treat patients without all the material that you need? Many health systems bracing for the impact of the COVID-19 pandemic have already been hammered to breaking point by war, political mismanagement, under-resourcing, corruption, austerity and sanctions. They are already barely able to cope with normal patient loads.

COVID-19 is demonstrating how policy decisions of social exclusion, reduced access to free healthcare, and increased inequality will now be felt by all of us. These policies are the enemy of our collective health.

As MSF scales up our response to the coronavirus COVID-19 pandemic, we will focus on the most vulnerable and neglected.

We started working in Hong Kong earlier this year in response to the first cases of COVID-19, and we now have medical teams deployed to respond in the heart of the pandemic in Italy. We will continue to scale up as much as is feasible as this crisis spreads.

However, there are decisions that can be taken now that will already ease the impending disaster that many communities may soon face. For example, the congested camps on the Greek islands need to be evacuated. That doesn’t mean sending people back to Syria where war still rages. It means finding a way to integrate people into communities where they will be able to practice safety measures such as social distancing and self-isolation.

In addition to this, supplies need to be shared across borders according to where the needs are the greatest. This needs to start with states in Europe sharing their supplies with Italy. It will soon need to extend to other regions that will be hit by this pandemic and whose ability to cope is already compromised.

As MSF, we will also need to manage the gaps we will face in staffing our other ongoing emergency projects. Our medical response to measles in DRC needs to continue. So too does our response to the emergency needs of the war-affected communities of Cameroon or the Central African Republic. These are just some of the communities we cannot afford to let down. For them, COVID-19 is yet another assault on their survival.

This pandemic is exposing our collective vulnerability. The powerlessness felt by many of us today, the cracks in our feeling of safety, the doubts about the future. These are all the fears and concerns felt by so many in society who have been excluded, neglected or even targeted by those in positions of power.

I hope COVID-19 not only teaches us to wash our hands, but makes governments understand that healthcare must be for all.

16 Mar. 2020

Challenges in supporting COVID-19 response

The COVID-19 pandemic has already spread to more than 100 countries around the world. These include countries whose health systems are fragile and where MSF teams have a long-standing presence, as well as regions such as Europe, where the capacities are more robust but where the epidemic is particularly virulent. Travel restrictions generated by the outbreak also directly affect MSF''s work around the world.

What questions does MSF face in this context? Clair Mills, MSF’s medical director, explains the challenges.

Are we right to be afraid of COVID-19?

Several factors make this virus particularly worrying. Being a new virus, there is no acquired immunity; as many as 35 candidate vaccines are currently in the study phase, but experts agree that no widely usable vaccine will be available for at least 12 to 18 months.

The case-fatality rate, which by definition is calculated only on the basis of identified patients and is therefore currently difficult to estimate accurately, appears to be around one per cent.

It is known that at least some of those people infected can transmit the disease before developing symptoms - or even in the absence of any symptoms. In addition, a very high proportion - around 80 per cent - of people develop very mild forms of the disease, which makes it difficult to identify and isolate cases quickly.

Confirmation of the diagnosis requires laboratory and/or medical imaging capabilities that are only available in reference structures, like teaching hospitals. It’s therefore not surprising that it’s proved impossible to contain the spread of the virus, which is now present in more than 100 countries around the world.

This epidemic then is very different from those - such as measles, cholera, or Ebola - in which Médecins Sans Frontières has developed our expertise over the last few decades.

Furthermore, it is estimated today that approximately 15-20 per cent of patients with COVID-19 require hospitalisation and six per cent require intensive care for a duration of between 3 and 6 weeks.

This can quickly saturate the healthcare system - this was the case in China at the beginning of the pandemic and is now the case in Italy. There are currently more than 1,100 patients in intensive care units in Italy and the hospital system in the country’s north, although well developed, has been overwhelmed by the rapid increase in the number of patients.

As is often the case during this type of pandemic, medical staff members themselves are particularly exposed to infection. Between mid-January and mid-February in China more than 2,000 health care workers were infected with the coronavirus (representing 3.7% of all patients).

This pandemic is likely to lead to the disruption of basic medical services and emergency facilities, the de-prioritisation of treatment for other life-threatening diseases, conditions and for other chronic infectious diseases everywhere but especially in some developing countries, where the health system is already fragile.

Some feel that the response to this epidemic is an overreaction, and that the remedies - border closures, quarantine, etc - are likely to be worse than the disease. Is this justified?

Even though they cannot prevent the outbreak from spreading, the measures currently being taken by many countries can slow it down by reducing the increase in cases and limiting the number of severe patients that health systems have to manage at the same time.

The aim is not only to reduce the number of cases but also to spread them over time, avoiding congestion in emergency and intensive care units.

What are MSF''s priorities in this context, and its main concerns?

Priorities for intervention vary from one context to another. In some areas that seem to be spared today, such as Central African Republic, South Sudan and Yemen, where fragile or war-torn health systems are already struggling to meet the health needs of people, protecting healthcare personnel and limiting the risks of spreading the disease as much as possible are needed.

This is done by implementing prevention programmes - identifying areas or populations at risk; running health awareness and information activities; distributing soap and protective equipment for healthcare personnel; and reinforcing hygiene measures in medical structures - to prevent our hospitals and clinics from becoming places where the disease is transmitted.

In countries where MSF has a longstanding presence we want to contribute to these efforts against COVID-19 while ensuring continuity of care against malaria, measles, respiratory infections, and other illnesses.

This continuity is now weakened by the restrictions (a ban on entering the country, preventive isolation for 14 days, etc.) imposed by governments on staff from certain countries, such as Italy, France and Japan, where some of our international staff come from, as well as the closure of borders and the suspension of certain air links.

Despite these constraints, our strength lies in the fact that we can rely on locally recruited staff in our countries of intervention. They represent 90 per cent of our employees in the field.

In countries where health systems are more robust but where the epidemic is particularly active, such as in Italy or Iran, the main challenge is to avoid overloading hospital care capacities. In these contexts, we can contribute to the efforts of national medical teams by making MSF staff available to support or relieve them when needed.

We can also help by sharing our experiences in triage and control procedures for infections acquired during epidemics.

We have provided teams to support four hospitals in northern Italy and have also offered support to the Iranian authorities to support them in caring for severe patients.

Depending on the evolution of the epidemic in France, we will make our experience, logistics and the know-how of our staff available to the response, if they can be useful.

One of the keys in the fight against COVID-19 is the availability of protective equipment, in particular masks and gloves used for medical examinations. The anticipation of shortages leads to requisitions by many countries, which can in turn become a reflex on the part of countries to monopolise these precious resources.

Right now, such equipment should rather be considered as a common good, to be used rationally and appropriately, and to be allocated as a priority to health workers exposed to the virus, wherever they are in the world.

Generally speaking, this pandemic requires solidarity not only between countries but at all levels, based on mutual aid, cooperation, transparency, the sharing of resources, and, in the affected areas, towards the most vulnerable populations and towards caregivers.